Provider Demographics
NPI:1093716219
Name:ROSENBERG, GENE S (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:S
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 915
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:201-343-0082
Mailing Address - Fax:201-488-1203
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 915
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-343-0082
Practice Address - Fax:201-488-1203
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03648000208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000052800OtherAMERICHOICE #
NJ5S1651OtherBCBS NY CARLSTADT
NJ0107212000OtherAMERIHEALTH HMO ID #
NJ21A961OtherBC/BS NY (HACKENSACK) #
NJ3055507Medicaid
NJ4093305OtherAETNA PPO ID #
NJ0049819OtherAETNA HMO ID #
NJBS025OtherOXFORD ID #
NJ1099931OtherGHI PPO ID #
NJ340010235OtherRAILROAD MDCR #
NJ4819209Medicaid
NJ3055507Medicaid
NJ4819209Medicaid